Diabetes and Endocrinology service
The diabetes centre at Bedford Hospital provides services to patients with diabetes and endocrine conditions.
We provide both in and outpatient services. The outpatient services are based in the diabetes centre on the second floor of the Cauldwell Centre. The centre has consultation rooms for doctors, nurses, dietitians and podiatrists. We also have a retinal screening room and a seminar room.
The inpatient service covers patients directly under the care of the consultants and an advisory service for patients with diabetes under the care of other consultants.
We have a multidisciplinary team of doctors, diabetes specialist nurses, specialist dietitians and specialist podiatrists. We also have an endocrine specialist nurse and a team of administrative staff who support the clinicians.
The department deals with the diagnosis and management of a diverse range of hormonal and metabolic disorders. It encompasses a wide variety of conditions ranging from those which are common, for example type 2 diabetes or polycystic ovarian syndrome, to those that are rare but eminently treatable such as pituitary tumours, multiple endocrine neoplasia and Addison’s disease.
We aim to provide a flexible and responsive service from a multi-professional team. We try to treat patients as individuals, recognising that a long term condition such as diabetes may affect many aspects of people’s lives. Our goal is to empower patients to enable them to manage their diabetes with confidence. We also have a telephone service for advice between appointments which is available on
We offer a young adult clinic for patients aged 16-21 years with diabetes, an adult diabetes service for any patient with type 1 diabetes and for patients with type 2 diabetes who’s GP recommends a specialist review. We also offer a specialist diabetes foot service for patients with diabetic foot problems and a joint antenatal/diabetes service with the obstetric service for pregnant ladies who have diabetes (this clinic is held in the Cygnet Wing). We provide counselling and advice for ladies with diabetes who wish to conceive and also run a dose adjustment for normal eating (DAFNE) course for adults with type 1 diabetes.
The endocrine service sees patients with thyroid disorders, pituitary disorders, PCOS, adrenal disorders, hirsutism, and other endocrine conditions. The clinic performs endocrine investigations and thyroid biopsies.
Most clinics are held in the diabetes centre except the the antenatal/diabetes clinic which is held in Cygnet Wing.
- Antenatal/diabetes clinic
- Diabetes foot clinic
- Diabetes follow-up clinic
- Endocrine/general medical new patient clinic
- Endocrine nurse investigation clinic
- General endocrine follow-up clinic
- High risk diabetes clinic
- Nephrology (satellite clinic from the Lister Hospital)
- Preliminary new patient diabetes clinic
- Young adult diabetes clinic (alternate weeks)
At the L&D the Multi-Disciplinary Diabetes Specialist Team offers a comprehensive range of diabetes services for in-patients and out-patients of all age groups, including Children and Young Persons (CYP). There are dedicated Diabetes Specialist Nurses (for adults and CYP), Specialist Dieticians, Specialist Podiatrists, and Consultant led consultations. For out-patients, most of the multi-disciplinary team specialist clinics are held in the dedicated Diabetes Centre or in the paediatric out-patient department.
CYPs with suspected diabetes are seen on the day of referral in the Paediatric Assessment Unit (PAU) and have open access to the unit with 24 hour expert advice for diabetes related issues. The Paediatric Diabetes Nurse Specialist, following diagnosis and when needed, support the family/child in the community setting and at their school. The team provide support and education for the staff at school to support the diabetes.
There is a close working link with both the Luton and Bedfordshire Integrated Community Diabetes Services.
A free diabetes information and advice website has been developed in conjunction with Bedford Hospital Diabetes Specialist Team, for health care professionals in primary care.
In addition to general diabetes clinics, the team can offer a wide range of specialist clinics and services:
- Diabetes in the Elderly (over 65s)
- Paediatric (Children)
- Young Adult / Adolescent
- Insulin Pump Clinic
- Adult General Diabetes Clinic (new and follow up)
- High HbA1c Clinic (Paediatric Diabetes Nurse led)
- Joint Diabetes Antenatal Clinic
- Joint Gestational Diabetes Clinic
- Pre-Conception Counselling Clinic
- Diabetic Foot Clinic
- Procedures and services
Procedures and services
- Assessment and management of complex diabetes
- Assessment and management of acute and chronic diabetes complications
- Insulin and injectable therapies initiation
- Continuous home blood glucose monitoring
- Structured education programs for patients
- Assessment and initiation of subcutaneous insulin infusion pump therapy
- Group educational services
- Rapid assessment and management of acute diabetic foot ulcers
- Support from Clinical Psychologist
- 1:1 Teaching on carbohydrate counting
The Diabetes Centre is located in Zone E of the hospital.
The L&D is one of the few hospitals providing a comprehensive endocrine service, encompassing common and uncommon endocrine disorders. We work in close collaboration with endocrine surgery, paediatric endocrinology and clinical biochemistry and the endocrine team in Cambridge, Oxford and Great Ormond Street Hospital.
The endocrine team runs out-patient clinics at the L&D to see new referrals and for follow-up of patients with complicated disorders. A high percentage of patients are discharged from their clinic follow-up after their acute problems have settled, but some of the complicated problems receive life long follow-up. The team also runs a consultation service for in-patients with endocrine disorders and endocrine emergencies. There is an Adult and Paediatric Endocrine Nurse Specialist, who runs nurse led follow up clinics, provides endocrine counselling to patients, pastoral care, and facilities endocrine function tests. There is also a joint endocrine adolescent clinic and outreach clinic from Great Ormond Street Hospital.
Any condition which indicates a hormonal dysfunction (thyroid, pituitary, adrenal, ovaries/testes) are seen in clinic. Other conditions seen are:
- Electrolyte and metabolic disorders
- Secondary hypertension
- Other rare disorders with a strong suspicion of endocrine cause
- Pregnant patients with endocrine problems can be seen at the request of a GP or obstetrics team
A good system of tests (requiring day admission) has reduced the need for patients travelling to Cambridge, Oxford, or Great Ormond Street Hospital for investigations or after their surgery in those centres.